Final Words & Summary
We cant overemphasize the importance of getting tested for diabetes. Its often recommended that people get tested occasionally and up to three times per year, even if they dont show any diabetes-related symptoms. This is because prediabetes barely presents any symptoms to indicate that you may have high blood sugar. At this stage, only a test diagnosis will help you determine if your blood sugar is too high or low.
The A1C blood sugar test and fasting blood glucose test are among the two reliable tests that a specialist can use to determine whether you have high blood sugar. If your blood sugar after the test swings in the high range or is considerably close to being abnormally high, you may need to take proactive steps to prevent you from slipping into full-blown diabetes.
This guide outlines some of the best steps patients can take to prevent the continuous rise in blood sugar and diabetes complications. As can be seen from the different management tips highlighted, exercise and dieting are the two major factors in reducing diabetes.
There are many ways patients can get foods that work for blood sugar. A dietitian is one of the best options, and so is a diabetes management app. However, the latter is often recommended due to the ease of use and the consistent update of the best tasty diabetes-friendly foods they offer.
A1c Is An Average Of All Your Blood Sugars
It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well youre doing.
Glysolated Hemoglobin is a measure of your average blood glucose control over the previous three months.
Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time.
The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells.
The A1c doesnt replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that dont vary too much.
How Is The A1c Test Used To Diagnose Type 2 Diabetes And Prediabetes
Health care professionals can use the A1C test alone or in combination with other diabetes tests to diagnose type 2 diabetes and prediabetes. You dont have to fast before having your blood drawn for an A1C test, which means that blood can be drawn for the test at any time of the day.
If you dont have symptoms but the A1C test shows you have diabetes or prediabetes, you should have a repeat test on a different day using the A1C test or one of the other diabetes tests to confirm the diagnosis.2
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What Could Cause A1c To Get Obstructed
Conditions like acute and chronic blood loss, hemolytic anemia, and splenomegaly can cause A1C values that are artificially low. The A1c readings of patients with end-stage renal illness are frequently artificially low. This is because of the chronic anemia that comes with it, which reduces red cell survival.
Target Levels In People With Diabetes
A doctor will set a persons target A1C level based on many factors. The right target varies from person to person.
For someone with diabetes, the target A1C level may depend on:
- the persons age
- how long they have had diabetes
- their prescribed treatment plan
- any history of adverse effects from the treatment, including episodes of low blood glucose, or hypoglycemia
- any complications from diabetes
- the persons preferences and treatment priorities
In general, a doctor might recommend aiming for A1C levels under 6.5% if a person:
- is young and has a long life expectancy
- has had diabetes for a short period
- is effectively managing their diabetes with lifestyle changes or metformin alone
- is otherwise in good health
A doctor might recommend A1C targets of 7.08.5% if a person:
- is older and has a shorter life expectancy
- has had diabetes for a longer period
- has diabetes that is hard to manage, even with multiple medications
- has a history of severe hypoglycemia or other adverse effects of treatment
- has experienced complications of diabetes
- has other chronic health conditions
A person should work with their doctor to reassess and adjust their A1C targets over time. The condition and treatment goals may change.
To screen for diabetes, a doctor may order an A1C test for someone older than 45. They may also do this for younger people who have other risk factors.
After diagnosing diabetes, a doctor determines how often to test A1C levels.
Symptoms of high blood glucose levels include:
What Happens If Blood Sugar Level Is Too High
If your blood sugar levels are too high then you risk developing diabetes. You can develop cardiovascular disease and nerve damage. With diabetes, the glucose in your blood does not reach your cells and can lead to these and other complications. Adding exercise and eating healthy can help to control your diabetes and prevent secondary diseases.
You may develop diseases and disabilities in the future, such as cardiovascular disease and nerve damage, if you have diabetes.
If your blood sugar levels are high then you can develop diabetes and risk developing cardiovascular diseases and nerve damage. Doing exercise and eating healthy is important to control your diabetes and prevent secondary diseases.
What Are Normal A1c Levels For People Who Don’t Have Diabetes
Generally, high A1c values indicate high average blood sugar levels and that a person might be at risk for or may have diabetes. The American Diabetes Association has established the following cutoffs:
Prediabetes, meaning at risk for developing type 2 diabetes
6.5% or greater
Make sure you get a regular A1c test, especially if you think you might be at risk for diabetes.
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Translating Your A1c To A Blood Sugar Level
Its easy to see an A1c result of 8.0 percent and think, Oh, my blood sugars are usually in-range. Everything is fine. But if you look more closely at what an 8.0 percent A1c really translates to as a blood sugar level, you may be surprised.
You can use this easy A1c/ eAG conversion chart from the American Diabetes Association to instantly translate your latest A1c result to an eAG.
You can read more about blood sugar levels in the post What are Normal Blood Sugar Levels?
The Big Picture: Monitoring Treatment
This relatively simple blood test can tell you a lot. The test results give you a picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes complications. Your doctor will tell you how often you need the A1C test, but usually youll have the test at least twice a year if youre meeting your treatment goals. If you’re not meeting your goals or you change treatments, you may need to get an A1C test more often.
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When Should I Get My Hemoglobin A1c Test
You should test your A1c levels as a preventive test if you are over 45 or under 45 and overweight. You should also consider it if you have one of the diabetes risk factors, such as:
- History of familial diabetes
- Low physical activity
- High blood pressure
- High level of blood cholesterol
- History of gestational diabetes or having given birth to a baby weighing over 9 pounds.
Check out your individual diabetes risk with our comprehensive diabetes risk calculator.
How The Test Works
The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound.
Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months.
If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher.
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Benefits Of Lowering Your A1c Test Result
Keeping your A1C test results low can significantly reduce the risk of long-term diabetes complications such as nerve problems, damage to your eyes, kidney disease and heart problems.3
1American Diabetes Association. Standards of medical care in diabetes2017 . Diabetes Care. 2017 40: S1-S135. Available at: . Accessed July 28, 2017.
2Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008 31: 1473-1478. Available at . Accessed July 28, 2017.
3American Diabetes Association. A1C and eAG. Available at: . Accessed July 28, 2017.
4Tylee TS, Trence DL. Glycemic variability: looking beyond the A1C. Diabetes Spectrum. 2012 24: 149-153. Available at . Accessed July 28, 2017.
How A1c Blood Sugar Test Compares With Fasting Plasma Glucose Test
Substantial research on HbA1C test comparison with fasting glucose test abound. These studies were designed to help doctors and diabetes experts determine which of the two most popular blood sugar tests is the most reliable. This section considers several of these scientific works to help patients know which test may be best for them at a particular time.
A 2010 study titled A Comparison of HbA1c and Fasting Blood Sugar Tests in General Population published in the International Journal of Preventive Medicine discussed how both tests play out in patients, pointing out their efficacy and reliability. The studys objective was to highlight the importance of early diagnosis of diabetes in reducing complications by sampling random respondents from 30 different parts of Kerman city.
To ensure a cross-sectional population study, the total number of people involved in the research was 604. The test compared the HbA1c and FBS with Karl Pearson correlation to highlight their specificity, predictive, and sensitivity values in detecting abnormal blood sugar levels.
The study showcased a strong correlation between the two tests effectiveness in detecting diabetes in its early stages. However, the research confirmed the FBG test to be far more accurate in confirming a persons blood sugar level, making it a more accurate test option than the Hb1AC test for early diabetes diagnosis.
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How To Lower Hba1c And Blood Glucose Levels
Adopt a more vegetarian diet, including beans & nuts
Vegetarian diets are inversely associated with the risk of developing type 2 diabetes. In a meta analysis comparing nine different experiments, researchers found that vegetarian diets consistently improved fasting blood glucose and HbA1c. Why? They generally emphasize a diet rich in whole grains, fruits, vegetables, beans, and nuts, and lower levels of saturated and trans fat. Plus, beans often replace meat in these diets by acting as a protein source. Thanks to their high fiber content and low glycemic index , beans stabilize blood glucose and insulin levels. So individuals with type 2 diabetes may notice significantly lower A1c levels if they increase their bean intake to at least one cup per day. Similar to beans, nuts are low glycemic and help regulate blood sugar levels. In a recent experiment, people who replaced some of their food with a serving of nuts saw improved glycemic control and HbA1c levels. On a grander scale, eating nuts has an inverse association with type 2 diabetesthat is, people who include nuts in their daily lives tend to have a lower risk of developing diabetes.
Exercise is a crucial component in managing glucose and insulin levels. It directly improves blood glucose control, increases insulin sensitivity, and helps maintain a healthy weight. Exercise is a very effective tool in preventing the development of type 2 diabetes.
Is The A1c Ever Inaccurate
The accuracy and effectiveness of A1C tests may be limited in certain cases. If you experience heavy or chronic bleeding, your A1C test may be falsely low. If you have iron deficiency anemia, B12 deficiency, alcoholism or kidney failure, your A1C test may be falsely high. These situations would make the A1C less representative of the average blood sugar, and would be less useful for people with diabetes.
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What Tools Are Available If An A1c Test Is Not Accurate Or Sufficient
Besides A1c tests, the most common measures of blood sugar are the oral glucose tolerance test , CGM, and self-monitored blood glucose tests.
The OGTT is a diagnostic tool diabetes and prediabetes, assessing a persons response to consuming a fixed amount of sugar. After taking the sugar drink, blood sugar levels are measured two hours later. Below 140 mg/dl is considered normal, between 140 mg/dl and 200 mg/dl points to prediabetes or impaired glucose tolerance, and above 200 mg/dl indicates diabetes. It is not useful for tracking diabetes management.
For those with established diabetes, CGM has the advantage of monitoring blood sugar levels consistently throughout the day , providing more detailed insight into time spent in-range, low blood sugars, and high blood sugars. Examples of CGM include:
Senseonics implantable Eversense CGM
If CGM is not available, taking frequent fingersticks with a blood glucose meter when waking up, before and after meals, and before bed can also indicate when blood sugar levels are going low, high, and staying in range.
Blood Glucose Levels Move Up And Down
Your results can vary because of natural changes in your blood glucose level. For example, your blood glucose level moves up and down when you eat or exercise. Sickness and stress also can affect your blood glucose test results. A1C tests are less likely to be affected by short-term changes than FPG or OGTT tests.
The following chart shows how multiple blood glucose measurements over 4 days compare with an A1C measurement.
Blood Glucose Measurements Compared with A1C Measurements over 4 Days
The straight black line shows an A1C measurement of 7.0 percent. The blue line shows an example of how blood glucose test results might look from self-monitoring four times a day over a 4-day period.
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How To Calculate A1c / Formula
It doesnt get any easier than utilizing our A1C calculator. Simply enter the level of hemoglobin A1C from your lab test to get an instant result. Both the hemoglobin and average blood sugar sections allow you to move freely between units.
Here is the formula for converting A1c to average blood sugar for people who are inquisitive about the details:
How Do We Measure Blood Glucose Levels
You can check your blood sugar levels at home using a portable device called a blood glucose meter. Ideally, your blood glucose level before a meal should be between 4.0 to 7.0 mmol/L. Two hours after a meal the level should be between 5.0 to 10.0 mmol/L. Find more on blood sugar level targets when you have diabetes in this article.
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How Does A1c Affect Blood Glucose Testing
If your A1C level is off target, you may need to test your blood sugar more frequently to determine when your levels are higher and if there is a pattern that can help your healthcare providers determine a treatment plan.
Of course, if your A1C levels are fine, you may not need to test as frequently. For more on how often to check your blood glucose levels go to this article.
Checking both your A1C and blood sugar levels regularly is an important way to stay on top of managing your diabetes.
Normal Blood Sugar Levels Chart
Every substance present in our body has an optimum level. Above or below that specific range, that particular substance is harmful to our health. And so is sugar. There is a certain range of blood sugar which is considered as standard for almost all age. However, there might be some changes in the level considering different factors like age and other co-morbidities. Lets look at the chart:
|2 hours after the meal
|< 140 mg/dl
Sometimes, random blood is also taken. In this case, the glucose level of 200 mg/dl is considered a diabetic condition.
Going through the chart you will notice certain terms regarding blood sugar which you need to understand in order to evaluate your own glucose level. So, I will just give a small brief regarding those:
- Fasting blood glucose: Here, blood sugar is tested after abstaining from food and drink for at least 8 hours.
- Postprandial blood sugar:In this case, blood sugar is tested 2 hours after a meal to access if its at the optimum level after having a meal or not.
- Random blood glucose: Blood is tested at any time of the day.
- HbA1c: It refers to a blood test which is done to evaluate the average level of blood glucose over the past 3 months. HbA1c is also known as glycosylated haemoglobin or A1C. Moreover, fasting is not required before carrying out the test.
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When To Take A1c Test
If youre over 45 or under 45 and overweight, test your A1c conversion as a preventive measure. You should also think about it if you have any of the following diabetes risk factors:
- Diabetes in the family history .
- Low levels of physical exercise .
- Blood pressure that is too high.
- A high quantity of cholesterol in the blood
- Have you ever had gestational diabetes or given birth to a baby that weighed over 9 pounds?